中医药治疗失眠伴焦虑状态研究进展

Progress in Treatment of Insomnia with Anxiety State with Traditional Chinese Medicine

失眠伴焦虑是一种典型的生理-心理疾病,以睡眠障碍、紧张、惊恐、易激等一系列躯体、精神不适为主要特征,已严重影响人们的身心健康和生活质量,给患者及家人带来极大的痛苦,并造成了沉重的社会及经济负担。失眠伴焦虑患者的失眠与焦虑互为因果,具有双向性。随着社会节奏不快加重,各种压力随之而来,失眠伴焦虑患者的人数有着不断上升的趋势。诸如性别、年龄、教育水平等可能是引起本病的相关因素。在中国古代典籍中,并无失眠伴焦虑这一病名的记载,但据其临床症状来看,相当于中医学中的“不寐”“脏燥”等范畴,病位在脑,病因多责之肝、胆、脾、胃、心、肾;“痰”“火”“气”是主要致病因素,病机以痰热内扰、肝郁化火、阴虚火旺居多;目前,西医对该病的治疗主要以镇静催眠药和抗焦虑药物对症为主,但治疗效果却不甚理想,并且存在不良反应大,药物依赖等弊端。大量实验及临床研究提示中医药治疗失眠伴焦虑状态获得了较满意的临床疗效,可有效改善其症状,缩短诊治疗程,降低复发率,减少并发症的出现。文章通过查阅文献资料,从病因病机、辨证分型、针灸治疗、中药治疗、其他治疗、针药结合等几方面对失眠伴焦虑的中医药治疗进展进行综述,为其研究提供参考。

Insomnia with anxiety is a typical physiological-psychosocial disease,characterized by a series of physical andmental discomforts such as sleep disturbance,nervousness,irritability,panic,etc.,which has seriously affected people’s physi-cal and mental health and quality of life. It brings suffering to patients and their family,and causes a heavy social and econom-ic burden. The insomnia and anxiety of patients with patients with insomnia and anxiety are mutually causal,and they are bidi-rectional. As the social unrest increases,various pressures follow,and the number of patients with insomnia and anxiety has arising trend. Such as gender,age,education level,etc. may be related factors that cause this disease. In ancient Chinese clas-sics,there is no record of the disease name of insomnia with anxiety,but according to its clinical symptoms,It is equivalent tothe categories of insomnia and irritability in Chinese medicine. The disease is located in the brain. The liver,gallbladder,spleen,stomach,heart,kidney. “phlegm”“fire”and“Qi” are the main pathogenic factors. The pathogenesis is mostly phlegm-heat internal disturbance,liver depression to transform fire,and yin deficiency and fire. At present,western medicine treatsthe disease mainly with sedative hypnotics and anti-anxiety drugs,but the treatment effect is not satisfactory,and there aredisadvantages such as large side effects and drug dependence. A large number of experiments and clinical studies indicate thattraditional Chinese medicine has achieved satisfactory clinical effects in treating insomnia with anxiety,and can effectively im-prove its symptoms. Shorten the course of diagnosis and treatment,reduce the recurrence rate,and reduce the occurrence ofcomplications. This article reviews the progress of Chinese medicine treatment of insomnia with anxiety form several aspectssuch as etiology and pathogenesis,syndrome differentiation,acupuncture treatment,Chinese medicine treatment,other treat-ments,acupuncture and medicine combination,and provides references for its research.